Reacción a "Prevención ambiental de drogas en la Unión Europea. ¿Por qué es tan impopular este tipo de prevención? de Gregor Burkhart"

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Are mass-media campaigns effective in preventing drug use? A Cochrane systematic review and meta-analysis.

OBJECTIVE: To determine whether there is evidence that mass-media campaigns can be effective in reducing illicit drug consumption and the intent to consume. DESIGN: Systematic review of randomised and non-randomised studies. METHODS: We searched four electronic databases (MEDLINE, EMBASE, ProQuest Dissertations & Theses A&I and CENTRAL) and further explored seven additional resources to obtain both published and unpublished materials. We appraised the quality of included studies using standardised tools. We carried out meta-analyses of randomised controlled trials and a pooled analysis of interrupted time-series and controlled before-and-after studies. RESULTS: We identified 19 studies comprising 184,811 participants. Pooled analyses and narrative synthesis provided mixed evidence of effectiveness. Eight interventions evaluated with randomised controlled trials leaned towards no evidence of an effect, both on drug use (standardised mean difference (SMD) -0.02; 95% CI -0.15 to 0.12) and the intention to use drugs (SMD -0.07; 95% CI -0.19 to 0.04). Four campaigns provided some evidence of beneficial effects in preventing drug use and two interventions provided evidence of iatrogenic effects. CONCLUSIONS: Studies were considerably heterogeneous in type of mass-media intervention, outcome measures, underlying theory, comparison groups and design. Such factors can contribute to explaining the observed variability in results. Owing to the risk of adverse effects, caution is needed in disseminating mass-media campaigns tackling drug use. Large studies conducted with appropriate methodology are warranted to consolidate the evidence base

GLI INTERVENTI PER LA PROMOZIONE DI UN\u2019ALIMENTAZIONE CORRETTA IN ITALIA

OBJECTIVES: to describe the prevention interventions conducted by the Regional health services to promote a healthy diet. MATERIAL AND METHODS: the database ProSA, which contains prevention interventions conducted by some Italian regions, has been analysed. Programmes identified as \uabDiet \u2013 physical activity\ubb were selected, and the ones that had the promotion of healthy diet in unselected populations as objective were included. Then, the programmes were analysed and described. RESULTS: a total of 87 programmes were included, 23 of which are certainly conducted during 2013-14. 91%are school-based, particularly targeted tomiddle schools, and 37%are based on classroomlessons.No programmemade any reference to specific evidence, while 11%of themcited scientific generic but relevant papers. 15% of the programmes described some evaluation process, but only 1% has proposed a study design with controls. Limiting the analysis to the region that contributed with the largest amount of recorded programmes, it can be estimated that programmes does not reached more than 0.03% of the general population, and 4% of the school population. CONCLUSIONS: in Italy, there is not a survey system to collect preventive interventions conducted by regional health authorities. The analysis of ProSA, an experimental system, allows us to highlight that the promotion of a healthy diet is based on interventions targeting only the school population and referring to scientific evidence in a very limited way. Moreover, they seem to cover very small part of the target population

Alcohol and the young: how does the press face the problem?

Background: alcohol is an important component of the Mediterranean diet and its moderate use is protective against cardiovascular risk. Binge drinking, i.e. the heavy consumption of alcohol over a short period of time, is the main consumption pattern of young people in Western countries and may lead to severe toxic effects in many organs. Mass media often address the issue by suggesting prevention measures; however, they may also have the unintended effect of encouraging alcohol misuse. This study aims to assess how the Italian press faces excessive alcohol consumption in young people, comparing the messages given by the press with scientific recommendations. Methods: articles published by the 6 best-selling Italian newspapers and the 4 best-selling Italian magazines were collected from October 15th to November 14th 2009. Medline database, governmental and non-governmental sources were searched for scientific recommendations regarding primary prevention of alcohol misuse. Press articles were described and analysed by filling out a predefined form. Results: fourteen newspaper articles regarding alcohol were found, 79% belonging to the news section. Six quotations of scientific recommendations were found: two about drink-driving, two about raising public awareness, one about Monitoring and Evaluation, and one about community and workplace action. Conclusions: scientific recommendations were often inadequately reported by the Italian press. The most covered recommendations, designed driver and public educational intervention, are also the least effective according to international literature. Therefore, a further effort is needed to tackle this issue in a more scientifically sound way

The use of Complementary and Alternative Medicine (CAM) among Italian children: A cross-sectional survey.

OBJECTIVE: To examine prevalence and modalities of CAM use in children living in Novara, a northern Italian city, and to estimate the prescription rate from paediatricians. METHOD: We administered a phone questionnaire to the parents of a sample of 147 children, asking questions about CAM use, children's health profile, parental socio-economic status, use modalities, effectiveness perceptions, and motivations. A parallel survey was conducted by e-mail by investigating family paediatricians attitudes about CAM. RESULTS: Among 147 children whose families responded to our survey 48.3% was treated with CAM at least once in life and 38,1% during the previous year. Children treated with CAM were on average younger than those who were not. The types of CAM used were herbal medicine and homeopathy. Parents who choose CAM for their children were more skeptical about vaccinations. CAM were most frequently used to treat pathologies of ear, nose and throat. 85.9% of parents was willing to use CAM in future, 78.9% would pass to conventional medicine if CAM failed. Among paediatricians 81.5% prescribed CAM at least once, but only 13.6% received specific CAM training. CONCLUSION: The prevalence of children using CAM in Novara is high, in line with investigations conducted in Northern European countries. The distribution of pathologies treated with CAM, parental socio-economic status and general scepticism towards vaccination are consistent with the literature. Physicians should keep themselves up-to-date also about evidence-based CAM therapies and, most importantly, should have an open dialogue about CAM with their patients

Media campaigns for the prevention of illicit drug use in young people.

BACKGROUND: Substance-specific mass media campaigns which address young people are widely used to prevent illicit drug use. They aim to reduce use and raise awareness of the problem. OBJECTIVES: To assess the effectiveness of mass media campaigns in preventing or reducing the use of or intention to use illicit drugs amongst young people. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2013, Issue 1), including the Cochrane Drugs and Alcohol Group's Specialised Register; MEDLINE through PubMed (from 1966 to 29 January 2013); EMBASE (from 1974 to 30 January 2013) and ProQuest Dissertations & Theses A&I (from 1861 to 3 February 2013). SELECTION CRITERIA: Cluster-randomised controlled trials, prospective and retrospective cohort studies, interrupted time series and controlled before and after studies evaluating the effectiveness of mass media campaigns in influencing drug use, intention to use or the attitude of young people under the age of 26 towards illicit drugs. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures of The Cochrane Collaboration. MAIN RESULTS: We included 23 studies involving 188,934 young people, conducted in the USA, Canada and Australia between 1991 and 2012. Twelve studies were randomised controlled trials (RCT), two were prospective cohort studies (PCS), one study was both a RCT and a PCS, six were interrupted time series and two were controlled before and after (CBA) studies. The RCTs had an overall low risk of bias, along with the ITS (apart from the dimension 'formal test of trend'), and the PCS had overall good quality, apart from the description of loss to follow-up by exposure.Self reported or biomarker-assessed illicit drug use was measured with an array of published and unpublished scales making comparisons difficult. Pooled results of five RCTs (N = 5470) show no effect of media campaign intervention (standardised mean difference (SMD) -0.02; 95% confidence interval (CI) -0.15 to 0.12).We also pooled five ITS studies (N = 26,405) focusing specifically on methamphetamine use. Out of four pooled estimates (two endpoints measured in two age groups), there was evidence of a reduction only in past-year prevalence of methamphetamine use among 12 to 17 years old.A further five studies (designs = one RCT with PCS, two PCS, two ITS, one CBA, N = 151,508), which could not be included in meta-analyses, reported a drug use outcome with varied results including a clear iatrogenic effect in one case and reduction of use in another. AUTHORS' CONCLUSIONS: Overall the available evidence does not allow conclusions about the effect of media campaigns on illicit drug use among young people. We conclude that further studies are needed.Research for and preparation of this article were supported by the National Institute on Drug Abuse (grants 3-N01-DA085063- 002 and 1-R03-DA-020893-01). The evaluation of the National Youth Anti-Drug Media Campaign was funded by Congress as part of the original appropriation for the campaign. The White House Office of National Drug Control Policy directly supervised the campaign. The National Institute on Drug Abuse supervised the evaluation; Westat, with the Annenberg School for Communication at the University of Pennsylvania as a subcontractor, received the contract. All authors were funded for this evaluation and other projects by the National Institute on Drug Abuse

Medium- and long-term health effects of earthquakes in high-income countries: a systematic review and meta-analysis.

BACKGROUND: Accurate monitoring of population health is essential to ensure proper recovery after earthquakes. We aimed to summarize the findings and features of post-earthquake epidemiological studies conducted in high-income countries and to prompt the development of future surveillance plans. METHODS: Medline, Scopus and six sources of grey literature were systematically searched. Inclusion criteria were: observational study conducted in high-income countries with at least one comparison group of unexposed participants, and measurement of health outcomes at least 1 month after the earthquake. RESULTS: A total of 52 articles were included, assessing the effects of 13 earthquakes that occurred in eight countries. Most studies: had a time-series (33%) or cross-sectional (29%) design; included temporal comparison groups (63%); used routine data (58%); and focused on patient subgroups rather than the whole population (65%). Individuals exposed to earthquakes had: 2% higher all-cause mortality rates [95% confidence interval (CI), 1% to 3%]; 36% (95% CI, 19% to 57%) and 37% (95% CI, 29% to 46%) greater mortality rates from myocardial infarction and stroke, respectively; and 0.16 higher mean percent points of glycated haemoglobin (95% CI, 0.07% to 0.25% points). There was no evidence of earthquake effects for blood pressure, body mass index or lipid biomarkers. CONCLUSIONS: A more regular and coordinated use of large and routinely collected datasets would benefit post-earthquake epidemiological surveillance. Whenever possible, a cohort design with geographical and temporal comparison groups should be used, and both communicable and non-communicable diseases should be assessed. Post-earthquake epidemiological surveillance should also capture the impact of seismic events on the access to and use of health care services

The role of music in promoting health and wellbeing: a systematic review and meta-analysis

Background: The higher disease burden and related costs due to an increasing aging population have placed tremendous pressure on the healthcare systems worldwide. Given that music, both listened and actively performed, promotes and maintains good health and wellbeing among the population, we sought to perform a systematic review that would assess its biopsychosocial effects on a population over 40 years of age. Methods: A comprehensive search of peer-reviewed articles up to April 2021 was conducted on six electronic databases (i.e. Cochrane, MEDLINE, PubMed, PsycINFO, Web of Science and Scopus). Our study population only included healthy adults of 40 years and older. A total of 11 randomized controlled trials (RCTs) matched the inclusion criteria and were therefore analyzed. Results: Despite the heterogeneity of the methodologies used in the selected studies, our findings suggest that active musical participation can lead to beneficial effects on both cognitive and psychosocial functioning, whereas the positive impact of listening to music seems to be predominantly restricted to the cognitive domain. Conclusions: Although our results are consistent with both active and passive music activities favouring health and wellbeing in individuals 40 years old and over, future prospective RCTs, employing more uniformed and sensitive measurements, should allow us to better gauge the role of music participation in healthy aging and longevity, especially in countries with a high population density of elderly people